MEDICARE: MS. ABIGAIL CHRISTINE GIANCOLA PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN9355631	FL

General Provider Information

NPI Number	:	1295192029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ABIGAIL CHRISTINE GIANCOLA PMHNP-BC

Provider Business Mailing Address
First Line	:	3835 N FREEWAY BLVD STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-1954
Country	:	US
Telephone Number	:	916-576-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 W PALMETTO PARK RD STE 407
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3425
Country	:	US
Telephone Number	:	855-501-1004
Fax Number	:	855-919-6172

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2016
Last Update Date	:	10/04/2024

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